婴儿乙型肝炎疫苗免疫效果评价

Assessment for immune effectiveness of hepatitis B vaccine among infant population

目的评价婴儿接种乙型肝炎疫苗的效果。方法回顾性分析2002-2012年北京市顺义区母亲为乙肝表面抗原(HBsAg)阳性和母亲为HBsAg阴性的婴儿(普通婴儿)接种乙肝疫苗后的血清学资料。结果 224例母亲为HBsAg阳性的婴儿中,HBsAg阳性者5例,阳性率为2.2%;HBsAb阳性者204例。219例HBsAg阴性婴儿和165例普通婴儿的HBsAb阳性率分别为93.2%和99.4%。母亲HBsAg、HBeAg双阳性者、母亲单阳性者(HBsAg阳性)及母亲HBsAg阳性、HBsAg不详者,3组的免疫效果差异无统计学意义(P>0.05)。母亲HBsAg阳性婴儿免疫效果比普通婴儿差(P<0.01)。母亲为HBsAg阳性的婴儿接种10μg剂量进口疫苗和10μg剂量"搭配接种方案"的免疫效果均优于5μg国产疫苗(P<0.05)。母亲HBsAg阳性是阻碍婴儿HBsAb产生的影响因素(OR=0.086,P=0.035)。结论顺义区现行乙肝免疫策略对母亲为HBsAg阳性的婴儿免疫效果较理想,但较普通婴儿效果略差。

Objective To evaluate the effect of hepatitis B vaccine among infant population in Shunyi District. Methods Infants＇ serological data after hepatitis B vaccination were analyzed retrospectively from 2002 to 2012 whose mothers were HBsAg-positive or HBsAg-negative（ordinary cases）. Results Among 224 infants whose mothers were HBsAg-positive,5 cases （2.2%） were HBsAg positive, 204 cases were HBsAb-positive. Of the above 219 HBsAg-negative infants and 165 ordinary cases, HBsAb-positive rate was 93.2% and 99.4% respectively. The mother was HBsAg and HBeAg double positive, single-positive （HBsAg-positive）, HBsAg-positive but HBeAg was unknown, the immune effect difference in the 3 groups was not statistically significant （P 〉 0.05）. The immune effects of infants whose mothers were HBsAg-positive were worse than those of ordinary infants （P 〈 0.01 ）. The immune effects of infants, whose mothers were HBsAg-positive, vaccinated 10 μg imported vaccine or 10 μg vaccine＂ with the vaccination program＂ were superior to those of 5 μg domestic vaccine （P 〈 0.05）. HBsAg-positive mother was unfavorable factor of infants producing HBsAb re- sponse （OR = 0.086, P = 0.035）. Conclusion The current hepatitis B immunization strategies in Shunyi district have good immune effects of infants, whose mothers are HBsAg positive, but worse than those of ordinary infants.